Web could be a useful HIV prevention tool in resource-limited countries

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Over a third of young adolescent Ugandans have used the internet to find information about HIV, according to study published in the November issue of PLoS Medicine, a freely available, open-access journal. As 45% of young people in the study had used the internet at least once and 66% said they would use the web to find out about HIV if access were free, the investigators believe that “online delivery of HIV/AIDS preventative interventions to adolescents in resource-limited settings appears promising.”

The internet is a well-established tool for the delivery of information about HIV, and access to the internet is expanding in many resource-limited countries, including areas of Uganda. The ability of the internet to deliver information to patients in resource-limited settings with a high HIV prevalence has not, however, been established. Therefore investigators in Mbarara, Uganda, recruited a population of 500 adolescents aged between twelve and 18 years at five schools to determine the extent of internet use; the proportion of those who had used the internet who had used it to find information about HIV; and the demographic characteristics of internet users.

Overall, 45% (223) individuals reported ever using the internet and a further 36% (230) said that they knew somebody who had gone online. Internet use was not even across the five schools in the study, and ranged from 11% to 91%. The school with a lowest level of internet use was a private, mixed sex Muslim school, whilst a state-run, all boys, non-denominational school (72%) and a private, Catholic girls’ school (91%) had the highest levels of internet use.

Glossary

sample

Studies aim to give information that will be applicable to a large group of people (e.g. adults with diagnosed HIV in the UK). Because it is impractical to conduct a study with such a large group, only a sub-group (a sample) takes part in a study. This isn’t a problem as long as the characteristics of the sample are similar to those of the wider group (e.g. in terms of age, gender, CD4 count and years since diagnosis).

Users of the internet appeared to be going online frequently, with 78% (175) reporting accessing the web during the previous week. Individuals whose mother had attended secondary school were significantly more likely to report internet use (p = 0.03), and those whose mother went to university were the most likely of all to report internet use (p = 0.002).

A total of 189 adolescents (38%) said that they had already used the internet to search for health information, with 173 (35%) reporting use of the web to find information about HIV and 102 (20%) information about sexual health.

Frequency of internet use was significantly associated with searching for information on HIV (p = 0.04), as were using chat-rooms and email, and playing games online. However, using the internet at school was inversely associated with accessing web resources about HIV. The investigators speculate that this could be because of blocking software or because of fears about privacy.

When the investigators looked at reasons why 55% (277) of the sample had never used the internet, they found that cost was the most commonly cited reason (43%, 118 individuals). Over a third (39%, 107) said that they did not know where to access the web, and 36% (101) reported not knowing how to use the web.

If internet access were free, two-thirds of adolescents said that they would use the web to search for information about HIV.

References

Ybara ML et al. Internet use among Ugandan adolescents: implications for HIV intervention. PloS Medicine 3: e433, 2006.